Thank you John Oliver and your staff for a significant public service on your show this week! Your commentary and excellent coverage of a major problem in substance use disorder and alcohol treatment will have an impact far beyond what the insurance and professional communities have been able to do.

MINES has patients who have gone out of network, received poor care, the payors have received outrageous bills, the patients are stuck with bills that can only result in medical bankruptcy and as you noted, people die in these disreputable facilities. A major component that you pointed out is patient brokering. When people Google substance abuse/use treatment, the top 20-30 are facilities, mostly in Florida and California, or are patient brokers. Reputable facilities in the person’s community do not even make the list. Then the facilities sometimes even pay the airfare to fly the patient to their facility and if the patient does not meet medical necessity for that level of care, the facility turns them out on the street to find their own way back to the state/community they live in.

You mentioned addictionologists as a resource for finding reputable care. In addition, Employee Assistance Programs as well as managed behavioral health services (insurance) are knowledgeable and informed about substance use and alcohol treatment. They know which facilities and programs are in network with the insurance and which ones do a good job.

Evidence-based treatment supports the use of a continuum of care from outpatient, intensive outpatient, partial hospitalization, residential and detox (medical and social detox). There are medications that also contribute to sobriety and health.

These are chronic illnesses/conditions that require the patients to cope with all their lives. Learning relapse prevention and adherence skills are essential.

If you decide to delve into this national problem further in a future episode, I would be happy to consult with you and your team.

Emoji-Mania

Today marks the release of the Emoji Movie. Reviews have been less than great, but love it or hate it, the movie’s central theme marks an interesting part of today’s communication methods and a sort of cultural phenomenon, the Emoji. Emojis have been around in Japan since the late 1990s but it wasn’t until 2013 when Emojis became available in all operating systems for phones and computers (https://en.wikipedia.org/wiki/Emoji). Emoji characters have led the charge for expressing oneself through pictures and being able to show how you are feeling depending on the situation.

This phenomenon has expanded into musicals (Emojiland), into TV shows, like Doctor Who’s episode “Smile”, and they are now even on the big screen with The Emoji Movie today.

Emoji-Speak

Emoji characters can say a lot in one character. You are able to express your inner feelings or use the secret Emoji language to ask things. The psychology behind this is fascinating and it will be interesting to see how pop culture will continue to influence these characters. You can instantly let someone know you are not happy with them and that email you sent that could be interpreted a few ways, really only should be interpreted in the fashion of the emoji sent.

Emoji-Evolution

One really interesting thing about emojis is how they have evolved to reflect the increasingly complex and nuanced use of emojis over time. What started as an inventory of simple smiley faces and objects have expanded into thousands of specific images representative of the population and communication styles that utilize them. We can see this in the ever-increasing inventory of emojis meant to represent various ethnicities, religions, occupations, and even sexual orientation. You can now find almost any combination of family structure and romantic couple in emoji form. On top of that, the different food emojis have expanded to include exotic and uncommon foods, a plethora of fruits and veggies, and of course the ever-popular pizza and burger icons. And that only scratches the surface when you look at the overwhelming number of facial expressions/smileys, animal variations, transportation, country flags, and event icons.

Emoji-Symbolism

Not only have the number of emojis increased dramatically over time but their use and meaning in the minds of users have as well. Many emojis today carry a meaning other than that of their literal form. For instance, fire or heart emojis can and are used to express love and affection, the various facial expressions carry with them all sorts of context dependent meanings, many icons of inanimate objects and food have a double meaning such as the use of the syringe icon to mean doctor or tattoo, while others carry sexual suggestiveness. Thanks to common use and social visibility of the internet, these double meaning have become widespread and understood, and is used similarly to an icon-based version of slang. But not just slang, slang that can be understood across languages and cultures.

Emoji-Communication

The biggest question is how do emoji characters fit into your work emails and communications. When you text that you are going to be out because you are sick, is using an emoj like the below good enough?With as many generations and generational differences the workplace is dealing with right now, using emojis is another example of what the younger generations (Millennials, and Gen Z) might find acceptable whereas Generation x and baby boomers may struggle with getting an email or text that you are sick. So where is the line? Is it ok to put a smiley face at the end of an email or an embarrassed face when you gave the wrong information, or do you still need to apologize and say you are embarrassed?

Emoji-Implications

The implications are endless and it will be fascinating to see where our workplace norms in regards to using Emoji characters go. I think the main thing to take away and think about when you are writing a communication, no matter what form that communication is in, is who your audience is and what type of communication it is. If your audience is a business associate outside your company, using an emoji may not be such a great idea. If you are writing a cease letter, you probably shouldn’t use:

Emoji-Conclusions

As you discover and consider the role Emojis play in your life, take the time to discuss it with others around you. It is fascinating to see what the different generations think of emojis and using symbols to show your emotions rather than just stating them. It is not only a great conversation piece and will help your social and intellectual wellbeing, it is a great opportunity to learn from others and think about their perspective to help influence how you will use them in the future.

As the parent of a seven year old, I’ve been enamored with the concept of “intentional parenting.” The essence of this philosophy is to think about the type of person you want your child to be when they become an adult and to give them age appropriate responsibilities to support their development. I, for one, am committed to raising a global citizen who has an appreciation for other cultures, languages, perspectives, and lifestyle choices.

I was exposed to traveling at a very early age and was always deeply appreciative that my parents expanded my horizons and perspectives through global travel. I’m sure my mom wasn’t completely surprised when I told her I had bought a one-way ticket to New Zealand and wasn’t sure when I would be back. And, sure enough, after two years of traveling out of a backpack, returned home to start graduate school. I loved the sense of intrigue and mystery that came with traveling to exotic lands and far away places.

I also came home with a profound sense of appreciation for the global diversity that we have right here! Looking at situations from a new perspective, asking open ended questions to understand a different point of view, and being curious about someone’s background or beliefs are all windows towards creating a sense of belonging to a global community. I feel so fortunate that much of the work I do in BizPysch – be it executive coaching, diversity training, or providing conflict mediation services – are all ways to build bridges and create a sense of community and connection.

Now, I’m getting ready to embark on another global adventure. As a parent who is committed to raising a “global citizen,” I am getting ready to move overseas with my son. We will be gone for a little less than a year and during that time we will both be students learning a new language and embracing a completely different way of living. There are so many ways to embrace global diversity, be it participating in a cooking class with foods from another country, learning a new language, seeing a foreign film, reading books about other countries, or following your curiosity by exploring new places on the internet! I trust I will return with a new set of perspectives which is what makes traveling and experiencing different cultures, no matter how you choose to do it, so exciting!

1988. This year was prominent for me because it’s the first year I have very strong memories. I watched my first love scene (Dirty Dancing), my first horror movie (Nightmare on Elm Street), and Charlotte’s Web taught me about death for the first time. But out of every memory I have from 1988, nothing – and I mean nothing – will ever compete with the horror I felt when my Dad made me eat liver for the first time.

I can still see it, smell it, and taste it. In fact right now, if I close my eyes, I can hear my Dad say, “You will not get up from that table till you finish your dinner. Just put ketchup on it.” I could smell it and was certain that I would get sick if I put it in my mouth; – and that’s just what I did – everywhere. As the crocodile tears poured from my eyes, I sobbed, “I knew I wouldn’t like it!”

I still can’t stand ketchup being anywhere near meat because of the liver incident. But I have always been thankful that my parents exposed me to so many different foods. There was even a year we went to a different ethnic restaurant every month. I would never wish liver upon my worst enemy (although I have heard people actually like it) but I hope that everyone explores out of their food comfort zone every once in a while; It can make for some unforgettable memories!

I will never forget one of my first meetings with a client after I became an Account Manager at MINES – I was slightly nervous but that feeling was enormously overshadowed by the excitement of learning about our client and how we could support their organization. Typically in these meetings, the excitement is followed by the hurdles the organization is facing. In this instance, the particular “hurdle” the organization was facing was generational gaps and the disruptive communication that went along with it. I couldn’t help but squirm in my chair as my client went on and on about how “twenty-something’s” just don’t understand. At first I was sitting there as a professional, the Account Manger, and in a flash I realized that I was a “twenty-something.” I couldn’t help but wonder if my co-workers felt this way about me because of our generational differences.

After that meeting, I became more cognizant of the differences between myself and my co-workers. I had always embraced it but I decided to learn from it. One of my favorite co-workers is a bit older (or as my Grandma says “wiser”) than I am. We won’t always see the world in the same way or handle work-related situations the same, but since I have been open to learning from her rather than focus on our age gap, she has taught me so much – from patience to tricky Mother-In-Laws.

Whether your workplace diversity is generational, cultural, or any difference you can think of, embrace it and learn from it. Please don’t forget to check out our Quarterly Wellness Magazine, Balanced Living Fall 2011 for great articles to financially ‘stay afloat’ in the downturn.